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Conditional Cash Transfer and Basic Needs Resolution Intervention for Low Income Adults with T2DM

Award Number: R01DK148601
ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/24/2026
PERIOD OF PERFORMANCE END DATE: 06/30/2031

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Conditional Cash Transfer and Basic Needs Resolution Intervention for Low Income Adults with T2DM - Diabetes affects 14.7% of the adult US population, is the 8th leading cause of death in the US, and 90- 95% of cases are due to Type 2 Diabetes (T2DM). T2DM is associated with significant morbidity, mortality, and health care costs. The burden of T2DM is even worse for low-income adults (i.e., individuals living below 133% of federal poverty level or are Medicaid eligible). These individuals have significantly higher prevalence, morbidity, mortality, and health care costs compared to higher income individuals. Despite advances in diabetes management, only 11.1% of adults with T2DM meet stringent criteria for the ABCs of diabetes, which are known to predict morbidity and mortality, including HbA1c < 7%; Blood pressure <140/90 mmHg; non- HDL–Cholesterol <130 mg/dL; and non-smoking; and only 36.8% meet less stringent criteria. Even more concerning is that for low-income individuals with T2DM only 1.2% meet stringent criteria and only 6.1% meet less stringent criteria. The bedrock of diabetes care is diabetes education and skills training (DSMES); however, the efficacy of DSMES in low-income adults with T2DM is limited by underlying social risk factors and poverty. Decades of research show that the underlying driver of social risk factors is poverty and it acts by limiting capacity and resources needed for optimizing health and clinical outcomes. Two interventions that have potential when combined to address social risks and underlying poverty are basic needs navigation and resolution (to address social risks) and conditional cash transfers (to address underlying poverty). Preliminary data from our group suggest that interventions that combine 1) diabetes education and skills training (to provide foundational diabetes education and skills training), 2) basic needs navigation and resolution (to identify, prioritize, and resolve unmet needs), and 3) conditional cash transfer (to offset financial pressure while supporting key health behaviors), have potential to improve clinical outcomes for low-income adults with poorly controlled T2DM. Therefore, we propose an RCT in which 300 low-income adults with poorly controlled T2DM (HbA1c >=8%) will be randomized 1:1:1 to: 1) a control group/enhanced usual care (UC); 2) diabetes education/skills training plus basic needs navigation/resolution (Educ+Basic Needs); and 3) diabetes education/skills training plus basic needs navigation/resolution plus conditional cash transfer (Educ+Basic Needs+CCT) and followed for 12 months to test whether addressing both social needs and underlying poverty is superior to addressing social needs alone on clinical outcomes; and whether both interventions are superior to usual care. Primary aim will test efficacy of the intervention on clinical outcomes (glycemic, blood pressure, and lipid control). Secondary aims will test intervention efficacy on self-care behaviors (diet, physical activity, and medication adherence), quality of life, evaluate cost effectiveness, and test direct and indirect pathways for intervention effect using structural equation modeling.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $800,434 )
2026	2026	THE RESEARCH FOUNDATION FOR THE STATE UNIVERSITY OF NEW YORK	520 LEE ENTRANCE STE 211	AMHERST	NY	14228	ERIE	USA	Diabetes, Digestive, and Kidney Diseases Extramural Research	000	1	8/24/2026	NEW	$800,434
														Subtotal = $800,434

Grand Total All Awards = $800,434

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Conditional Cash Transfer and Basic Needs Resolution Intervention for Low Income Adults with T2DM

Award Number: R01DK148601

ORGANIZATION: NATIONAL INSTITUTE OF DIABETES & DIGESTIVE & KIDNEY DISEASES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/24/2026

PERIOD OF PERFORMANCE END DATE: 06/30/2031

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